2 research outputs found
myomterial invazyon paterninin prognostik önemi: Retrospektif bir çalışma
Objective: Endometrioid endometrial carcinomas (EEC) are the most
commonly diagnosed malignancies of the female genital tract. Myometrial
invasion depth is one of the most significant pathological prognostic
parameters. Different morphological invasion patterns have been
characterized. This study aimed to investigate the prognostic significance
of the microcystic elongated and fragmented (MELF) myometrium
invasion pattern in patients with EEC and its relationship with other
clinicopathological parameters.
Methods: This study included 101 patients with EEC in our institution
between 2011 and 2020. The MELF pattern was evaluated in hematoxylineosin-stained sections. Pan-cytokeratin staining was performed on
paraffin-embedded blocks of lymph nodes for cases without lymph node
metastasis.
Results: The MELF pattern was observed in 29 (29.8%) patients. It
was significantly associated with lymphovascular invasion (p<0.001),
pathologic stage (p=0.048), infiltrative pattern (p<0.001), and necrosis
(p=0.005). No significant correlation was observed between the MELF
pattern and overall and disease-free survival rates.
Conclusions: The MELF pattern is associated with other prognostic
parameters, but its prognostic significance for survival has not been found.
If the MELF pattern is observed in the hysterectomy material for cases
without lymph node dissection during the first surgery, these patients
may need additional surgery or adjuvant therapy due to the high risk of
lymphovascular invasion and lymph node metastasisAmaç: Endometrioid endometriyal karsinomlar (EEK) kadın genital
sistemin en sık karşılaşılan maligniteleridir. Myometrium invazyon
derinliği en önemli patolojik prognostik parametrelerden birisidir.
Farklı morfolojik invazyon paternleri tanımlanmıştır. Biz çalışmamızda
EEk olgularında mikrokistik elonge fragmante (MELF) myometirum
invazyon paterninin prognostik önemini ve klinikopatolojik
parametrelerle ilişkisini araştırmayı amaçladık.
Yöntemler: 2011-2020 yılları arasında kurumumuzda EEK tanısı alan
101 hasta çalışmaya dahil edildi. Hematoksilen eozin kesitlerde MELF
paterni değerlendirildi. Lenf nodu metastazı izlenmeyen olgularda lenf
nodu bloklarına pan-sitokeratin uygulandı.
Bulgular: Yirmi dokuz hastada (%29,8) MELF paterni izlendi. MELF
paterni lenfovasküler invazyon (p<0,001), patolojik evre (p=0,048),
infiltratif patern (p<0,001), ve nekroz (p=0,005) ile anlamlı ilişkili
izlendi. Genel ve hastalıksız sağkalımda MELF paterni istatistiksel
olarak anlamlı ilişkili izlenmedi.
Sonuçlar: MELF paterni diğer prognostik parametrelerle ilişkili
olup tek başına prognostik önemi saptanmamıştır. Ancak ilk cerrahi
sırasında lenf nodu diseksiyonu yapılmayan EEK hastalarında
histerektomi materyalinde MELF paterni saptanması durumunda
yüksek lenfovasküler invazyon ve lenf nodu metastaz riski nedeniyle
ek cerrahi işlem ya da adjuvan terapi kararında MELF paterni varlığının
dikkate alınması gerektiğine inanıyoruz
Tumor budding is an independent prognostic factor to predict overall survival in endometrial endometrioid carcinoma: A retrospective study
Objective. Tumor budding defined as a tumor cell nest away from the main tumor, has been found to be associated with prognostic parameters in many cancer types. We aimed to investigate the relationship between tumor budding and clinicopathological parameters in endometrioid endometrial carcinomas, as well as its prognostic importance. Materials and Methods. One hundred four patients who underwent surgical resection with diagnosis of endometrioid endometrial carcinomas between June 2011 and May 2020 were included. The area where tumor budding was the most prominent was determined, and tumor budding was counted from hematoxylin and eosin-stained section at one high power field (X 200). By performing ROC analysis, the cut off value was obtained in order to divide the patients into low and high tumor budding groups. Results. The cut off value was determined as 1/0.95 mm(2) according to the ROC analysis. Tumor budding was observed in 24 (23%) patients. Tumor budding significantly associated with poor overall survival (P < .001), distant metastasis (P = .001), presence of angiolymphatic invasion (P < .001), lymph node metastasis (P = .024), cervical invasion (P < .001), high FIGO grade (P < .001), large tumor size (P = .004). In multivarate analysis, tumor budding and age were found to be an independent risk factor for overall survival (P = .003, P = .014 respectively). Conclusion. Tumor budding is a significant morphological parameter independent of other prognostic parameters in endometrioid endometrial carcinomas. Standardizing the assesment and scoring of tumor budding, as well as including this entity in routine pathology reports could light the way for ideas in the risk analysis of patients